Rendimiento diagnóstico de los hallazgos ecográficos de los nódulos tiroideos en la detección de lesiones malignas |
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| Authors: | Abel González-González Alberto Mate Valdezate Almudena Parra Arroyo José M Tenías Burillo |
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| Institution: | 1. Sección de Endocrinología y Nutrición, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España;2. Servicio de Anatomía Patológica, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España;3. Servicio de Medicina Interna, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España;4. Unidad de Apoyo a la Investigación, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España;1. Department of Surgery, University of Wisconsin, Madison, Wisconsin;2. Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Wisconsin, Madison, Wisconsin;3. Department of Pathology and Laboratory Medicine, University of Wisconsin, Madison, Wisconsin;1. Department of Veterans Affairs Medical Center, VA Outcomes Group, 111B, 215 North Main Street, White River Junction, VT 05009, USA;2. Section of Otolaryngology, Geisel School of Medicine at Dartmouth, Rope Ferry Road, Hanover, NH 03755, USA;3. The Dartmouth Institute for Health Policy and Clinical Practice, 35 Centerra Parkway, Lebanon, NH 03766, USA;4. Division of Thyroid and Parathyroid Surgery, Department Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA;5. Division of Surgical Oncology, Massachusetts General Hospital, 55 Fuit Street, Boston, MA 02114, USA;1. National Cancer Institute, University of Gezira, Wadmadani, Sudan;2. Faculty of Medicine, University of Gezira, Wadmadani, Sudan;3. Department of Comparative Pathobiology and Purdue University Centre for Cancer Research, Purdue University, West Lafayette, IN, USA;1. Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus;2. Endocrinology Department, Archbishop Makarios III Hospital, Nicosia, Cyprus;3. Radiology Department, Archbishop Makarios III Hospital, Nicosia, Cyprus;4. Medical Oncology Department, Prof. Dr. Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania;5. Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania;6. Nuclear Medicine Department, Prof. Dr. Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania |
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| Abstract: | ObjetiveTo evaluate the diagnostic efficiency of sonographic findings (nodule size, the presence of microcalcifications and echogenicity) compared with the results of fine-needle aspiration biopsy (FNAB) of thyroid nodules.MethodsThe results of cytology and the ultrasound characteristics of 341 thyroid nodules were analyzed.ResultsA total of 25.5% of the FNAB were inadequate, 65.1% were benign and 7.9% were suspicious or malignant. The percentage of inadequate samples was clearly larger in nodules smaller that 15 mm but that of malignant cytologies was also larger in this group of nodules (11.1 versus 2.8%: p=0.04). The percentage of inadequate samples among nodules smaller than 10 mm was 66.7% and no malignancies were detected. A notable finding was the absence of suspicious or malignant FNAB in hyperechogenic and anechogenic nodules. In contrast, the echogenic feature most frequently associated with malignancy was hypoechogenicity, although echogenicity, as a whole, was not significantly associated with malignancy (p=0.313). Most cases with microcalcifications (6 of 10) were malignant compared with four of the 239 nodules (1.7%) without calcifications (p<0.001). Multivariate logistic regression revealed that the only variable maintaining a significant association with malignancy was the presence of microcalcifications.ConclusionsThyroid cytology is an efficient method to evaluate thyroid nodules larger than 10 mm. The presence of nodule microcalcifications is significantly associated with malignancy, while hyperechogenicity and anechogenicity are associated with benign nodules. |
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